NPIMap

Organization Active NPI

Staten Family Practice PLLC

  • Clinic/Center
  • Gillespie, IL
National Provider Identifier
1407474083
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
STATEN FAMILY PRACTICE PLLC
Practice address
500 W Virginia Ave
Gillespie, IL 62033-1025
Phone
(217) 851-5270
NPI assigned
Jul 9, 2020
Last updated
Jul 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rosemary Staten, FNPNPI 1376809525
Title
Aprn
Phone
(217) 851-5270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

500 W Virginia Ave
Gillespie, IL 62033-1025

Mailing address

500 W Virginia Ave
Gillespie, IL 62033-1025
Phone (217) 851-5270

Other names 1

  • Staten Family Practice PLLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1407474083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W VIRGINIA AVE",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331025",
            "telephone_number": "217-851-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W VIRGINIA AVE",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331025",
            "telephone_number": "217-851-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "STATEN",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "217-851-5270",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Staten Family Practice PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gillespie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.